Sale Request Form - Broadridge Financial Solutions
Sale Request Form
Broadridge Corporate Issuer Solutions
P.O. Box 1342
Brentwood, NY 11717-0718
Phone: 1 (855) 55-DISNEY (1-855-553-4763)
Fax: 1 (215) 553-5402
Dear Disney Shareholder,
Broadridge Corporate Issuer Solutions is the transfer agent for The Walt Disney Company. The information provided
below outlines the process to sell shares from your account. Please read the content carefully and follow all of the
instructions provided.
Things to remember before sending in your completed form:
1. Make sure your form has all of the required signatures. If the account has a joint tenant registration, both shareholders
are required to sign. If you are signing for the shareholder, please include your title (e.g., POA, Custodian, Executor) after
your signature and the proper documentation supporting your title if applicable (e.g. appointment documents).
2. If the shares are held in certificate form, you must enclose the certificate(s) with your request.
3. Consult The Walt Disney Company Investment Plan Prospectus for additional information regarding a sale of shares,
including account terminations, along with transaction fees and associated brokerage commissions.
If you have any questions regarding your Disney Shareholder account, please contact us at:
Telephone Number: 1 (855) 55-DISNEY (1-855-553-4763)
E-mail: disneyshareholder@
Please retain a copy of all documents for your records. Please return the above items via fax (not applicable for
certificated shares) or mail them to:
Regular Mail Overnight Mail
Broadridge Corporate Issuer Solutions
Broadridge Corporate Issuer Solutions
P.O. Box 1342
OR
1155 Long Island Avenue
Brentwood, NY 11717-0718
Edgewood, NY 11717-8309
Attn: IWS
Thank you for your interest in The Walt Disney Company.
Sincerely,
Correspondence Department
Broadridge Corporate Issuer Solutions
DISHSLRQ - V11
Sale Request Form
You can sell shares held in book entry (electronically) anytime at .
USE THIS FORM TO REQUEST AND AUTHORIZE BROADRIDGE TO SELL SHARES FROM THE FOLLOWING ACCOUNT:
Account Registration: (Example: John Smith OR John Smith and Mary Smith JT)
Account Number: 1683 -
Daytime Telephone No.: __________________________________
SALE SPECIFICS
Sell this number of shares:
Plan Shares
(Example: 123.44)
,
.
Certificated Shares
(Example: 120.000)
,
.
(Original certificate(s) must be enclosed to process)
Book Entry Shares
(Whole Shares)
,
.
OR
Sell ALL shares and close account.
(Original certificate(s) must be enclosed to process, if applicable.)
AUTHORIZED SIGNATURE
The signature of all owner(s)/authorized parties is required to process this transaction: I (the undersigned), as a participant
in The Walt Disney Company Investment Plan administered by Broadridge, acknowledge that Broadridge is acting solely as a service
provider on behalf of The Walt Disney Company. Broadridge is not acting as a broker-dealer, and will not execute any sale on your
behalf. Rather, Broadridge will promptly forward your request to the registered broker-dealer utilized by The Walt Disney Company
Investment Plan who will sell the shares on the open market pursuant to the terms in the Plan Prospectus. The proceeds remitted will be
reflected net of administration fees and brokerage commissions. Shares are sold at market prices and at the frequency set forth in the
Plan Prospectus. Depending on the number of shares being sold and the current trading volume in the shares, sales may be executed in
multiple transactions and may occur on more than one day. The selling price will not be known until the sale is complete. A check for the
proceeds of the sale of shares, less applicable taxes, transaction fees and brokerage commissions, together with a summary transaction
statement, will normally be mailed to you by first class mail within two (2) business days after the final trade settlement date.
If you utilize The Walt Disney Company Investment Plan, you will not be a brokerage customer of Broadridge or the registered
broker-dealer utilized by The Walt Disney Company Investment Plan.
Broadridge¡¯s role in administering The Walt Disney Company Investment Plan is purely ministerial and clerical. Broadridge does not
warranty or guarantee execution quality or fulfillment of sale requests. Finally, Broadridge will not be liable for any losses or liability
you may incur arising from, related to, or in connection with your participation in the Plan, or Broadridge¡¯s actions or non-actions
with respect to the Plan, and you hereby agree to indemnify and hold harmless Broadridge from all losses and liabilities incurred by
Broadridge in connection with your participation in the Plan.
By way of submitting the applicable enrollment fee, if the account is not already enrolled in The Walt Disney Company Investment Plan,
and signing below, I/we acknowledge reading the Plan Prospectus and agree to its terms (The Walt Disney Company Investment
Plan Prospectus is available at ).
_________________________________________________________________
_________________________________
Signature Date
_________________________________________________________________
_________________________________
Signature Date
DISHSLRQ - V11
................
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